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tenncare reimbursement

Found inside – Page 360The reason for such speed was the anticipated opposition from the state's greatest organized special interest group , the Tennessee Medical Association . medical association felt that TennCare's reimbursement rates would be inadequate ...

Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. Found inside – Page 537Increases to premiums and co-payments, reductions to provider reimbursements, and limits on provided services were ... TennCare In 1993, Tennessee, motivated by problems similar to those in Oregon (an increasing portion of the state ... HHS describes Medicare as an insurance program, whereas Medicaid is an assistance program. Previous bookmarks no longer work because of the transition to a new cloud platform. Reimbursement Guidelines for Unusual Procedural Services . 3. Yes. The MCO must pay the hospice 95% of the Nursing Facility’s per diem, as established by the Comptroller’s Office for the Bureau of TennCare, for the enrollee’s room and board. TennCare Crossover Payments for Medicare Deductibles and Co-Insurance. If there are no extenuating circumstances (spouse, minor child, etc.) Additionally, QuILTSS offers programs dedicated to the development of the LTSS workforce. Reference to Puerto Rico Medicaid Page: Puerto Rico Medicaid Link to Provider Page: Provider Portal Website ... TennCare Providers Texas Blue Cross and Blue Shield of Texas Yes Yes, but also must enroll with TX STAR Program. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society. Tennessee’s CHOICES program was designed by TennCare over a decade years ago to rebalance long-term care delivery in our state to offer services and help eligible seniors (age 65 … Found inside – Page 63Unable to revise its methods of operation and with TennCare reimbursement so low, the public health department closed 5 neighborhood primary care sites and eliminated primary care, except for mandated public health services like ... The mileage reimbursement program is a voluntary program chosen by TennCare members to meet your non­ emergency medical transportation needs.All transportation must still be scheduled through the Tennessee Carriers Call Center at the number listed below: The case required the appeals court to determine whether the rule falls under the UAPA. The Jan. 1, 2021, effective date does NOT apply to Arizona, Kansas, Mississippi, Nebraska, New Jersey, Tennessee or Texas. The present work is a "master index" to the case files of the Commission. Parent does not reside in the same household as …

If you don’t have a way to get to your health care visits, you can get a ride to and from services covered by TennCare. These include: Call Tennessee Carriers at 1-866-680-0633. It’s a free call. Call at least three days before your appointment. Tell them about any special needs you may have (such as a wheelchair, cane, or walker). Found inside – Page 671Caremark would also routinely deny TennCare's reimbursement requests as untimely . In December 2003 , Caremark filed an action against TennCare seeking a declaration that TennCare's thirdparty claims were subject to the card ... For reimbursement requests from a parent for a child (under the age of 18) when the requesting parent meets both of the following requirements: 1. "Our main source of revenue is managed care," Freeman said. Chapter 1200-13-01 - TennCare Long-Term Care Programs. What this means is a decedent's heirs cannot intentionally wait more than 12 months after date of death to open a probate and thereby avoid TennCare's claim for reimbursement, if applicable. In 2021, the State of Tennessee will spend up to $78,325 on each TennCare member receiving care in a nursing home or other facility. ... Southeastrans offers public transportation … Tennessee currently has an entirely managed care Medicaid reimbursement system, known as TennCare, authorized under a waiver. UnitedHealthcare Plan of the River Valley has entered into a contractor risk agreement (CRA) with the State of Learn how to bill Cpt Code 90834 accurately every time with our insurance billing guide. TennCare will provide pharmacies with final guidance before April 1, 2017, pending ongoing conversations with CMS. Found inside – Page 63Unable to revise its methods of operation and with TennCare reimbursement so low , the public health department closed 5 neighborhood primary care sites and eliminated primary care , except for mandated public health services like ... 12. The proposed 2% reduction will be reinstated for FY 2016 unless additional appropriations are provided to buy back the reductions in whole or in part. The Court of Appeals in Nashville, Tenn., ruled that TennCare, the state's Medicaid program, did not violate a state law when it imposed a $50 … Long-Term Services & Supports. In 1-866-473-7565 Member ID Required to Schedule . In May 2011, Aon completed the analysis of the extent of variation and found the following level of variation in hospital reimbursement based on 2009 hospital TennCare claims data: Provider newsletter message: Pharmacy 90 Day Prescription. If you are a new RHC, you can now submit your quarterly Tenncare Wrap reports and recieve interim reimbursement at the average rates established by Tenncare for each of the Grand Divisions of Tennessee. Medical Necessity. Medicare See Telemedicine Reimbursement Guide – Medicare Section. October 15, 2021. Bus passes are available in some cities where bus systems operate. Found inside – Page 46-285nCare's MCO and Provider Networks hreatened he success of TennCare will also depend on continued participation of the MCOs and ... Officials said that efforts to reduce provider reimbursement would jeopardize their providers ' continued ... 42 CFR § 435.406(b) states that applicants who may obtain emergency medical services are: residents of the State who otherwise meet the eligibility requirements of the State plan (except for Found inside – Page 764TennCare payments are so low that physicians , hospitals , pharmacists and other providers of health care will leave ... A privatized , market - driven system like TennCare will move the system to an appropriate level of reimbursement . A release is proof that the agency won't seek reimbursement from the estate for nursing home or home care received by the deceased person. 15. Audience: BlueCare Tennessee . File a Request for Release with TennCare, the state Medicaid agency. Section 1200-13-01-.08 - PERSONAL NEEDS ALLOWANCE (PNA), PATIENT LIABILITY, THIRD PARTY INSURANCE AND ESTATE RECOVERY FOR PERSONS RECEIVING LTSS. The QuILTSS initiative includes outcome-based reimbursement for services such as Nursing Facility Care, Enhanced Respiratory Care, Home and Community Based Services, Behavioral Health Crisis Prevention Intervention, and Stabilization Services.

TennCare Initial HCBS Spending Plan Projection & Narrative Institute Presentations Improve Performance & Outcomes Today To Prepare For The Future Value-Based Reimbursement Landscape: A Look At Credible EHR’s Business Intelligence & Analytics—Sponsored By … An MCO may request an exception from TennCare to the moratorium on reimbursement for Enhanced Respiratory Care upon the MCO's demonstration of the need for additional capacity or improved quality in the geographic area in which the NF is

Found inside – Page 327TennCare's structure includes significant financial incentives for health plans to maintain quality of care . ... Initial per capita spending targets and provider reimbursement will be based on the actual medical care costs plus a ... 22 Century Blvd. Are you a provider who needs assistance with TennCare related matters? Found inside – Page 10The greatest challenge is the extremely low reimbursement rate paid for TennCare/Medicaid patients in Tennessee. The per capita expenditures for Medicaid in Tennessee are the lowest in the nation. Vine Hill and the expansion sites face ... Dr. Ogbonna provides a template for dealing with policy, managerial, and administrative issues of rising healthcare costs in Tennessee and the nation in general. Tenncare Medicaid eligibility levels. TennCare requires providers to file these codes. service (FFS) reimbursement models has been fueled in large part by the Medicare program, which has rolled out a number of programs that shift payment toward value, including the Medicare Shared Savings Program (MSSP) in 2011. All Rights Reserved. Lucas is charged with five counts of health care fraud. From in or around October 2018 to the present, Lucas allegedly caused his pharmacies to submit nearly $4 million in claims to Medicare and TennCare for dispensing expensive foot bath medications that were not medically necessary and would not have been eligible for reimbursement. Found inside – Page 668Increases to premiums and copayments , reductions to provider reimbursements and limiting provided services were ... TennCare In 1993 , Tennessee , motivated by problems similar to those in Oregon ( an increasing portion of the state ... A recent audit of Tennessee Medicare found that of the $2 billion in certified public expenditures it … TennCare released the memo on November 2, 2021. Amerigroup Community Care wants to ensure that our members have uninterrupted access to medications during the COVID-19 threat.

The Court of Appeals in Nashville, Tenn., ruled that TennCare, the state's Medicaid program, did not violate a state law when it imposed a $50 reimbursement limitation for nonemergent medical services provided by emergency department physicians, according to court documents filed Oct. 7. Amerigroup Community Care is committed to supporting you in providing quality care and services to the members in our network. An addition to hospice reimbursement is made in this situation to take into account the room and board provided by the facility. Select . This document describes the guidelines for TennCare reimbursement of school nursing services as required by the IEP: The services (in the following table) performed by the school nurse are ordered by the child’s treating TennCare has worked diligently to decrease barriers to voluntary Long-Acting Reversible Contraception (vLARCs) for members. The amount includes $482.1 million of excess certified public expenditures TennCare allegedly claimed but did not return after calculating the actual expenditures. The rates are as follows: TennCare Enrollees may not be charged for personal laundry services. Contact Tennessee Carriers at 1-866-680-0633 (TTY 711) to learn more about … Nashville, TN 37243 . Found inside"Anyone would be when they see their reimbursement base almost evaporate." Particularly controversial was TennCare's impact on Tennessee's landmark public hospital, the 165-year-old Regional Medical Center in Memphis, known as the Med. Cookie Policy. IMPORTANT TENNCARE UPDATES REGARDING COVID-19 HEALTH CONCERNS: The primary concern of TennCare is to ensure members have uninterrupted access to medication during the COVID-19 threat.Temporary procedures have been deployed to … Found inside – Page 22... 1994 and 1996 , TennCare reimbursement per visit decreased by over 7 percent . The consultants estimated that , for 1997 , payments from TennCare fell short of covering the costs of C / MHCs in the state by over $ 9 million . Found inside – Page 99Articles variously refer to reimbursement of some specialists at less than 20 % of normal fees , but the average was about 35 % . One hospital bill for a heart transplant on a TennCare patient was reportedly negotiated down from ... … TennCare will not provide reimbursement for EMS if an applicant meets the citizenship criterion for regular TennCare Medicaid eligibility. TennCare’s language regardingthe reimbursement policy for emergency room physicians. TennCare Kids Billing and Reimbursement Coding TennCare Kids periodic screenings using appropriate preventive CPT® codes will help ensure providers receive the highest level of reimbursement possible. NEMT is a service that is provided to BlueCare and TennCare Select Medicaid Members who require transportation assistance to Medicaid-billable healthcare services and have no other means of transportation. Providers. TennCare will cover the cost to administer the vaccines to the following members through their Pharmacy Benefit Manager (PBM): IMPORTANT NOTICE DUE TO COVID-19 EMERGENCY Temporary Guidance Regarding Provider Administration Manual Southeastrans understands the challenges of providing transportation services because many of our employees and managers were once transportation providers. 14. Chinyere Chigozie Ogbonna-McGruder, Tennessee State University. Also, definitions for terms used in … The original proposed reduction was 2% however 1% was bought back with one-time appropriations for FY 2015. Funding for the plan is through the American Rescue Plan (ARP). Found inside – Page 329was ( and is still ) experiencing extreme difficulties in obtaining earned reimbursement from TennCare managed care organizations ( MCOs ) . As a result , Tennessee's largest publicly funded provider has begun closing key services ... The reimbursement now jeopardizes the care of all TennCare … (a) An ICF/MR that has entered into a provider agreement with the Bureau of TennCare is entitled to receive Medicaid reimbursement for covered services provided to an ICF/MR Eligible if. Copyright © 2021 Becker's Healthcare. TennCare will determine pharmacists’ eligibility based on numerous factors, including provider location and completion of the required steps listed below. Use your TennCare Connect online account at https://tenncareconnect.tn.gov. What this means is a decedent's heirs cannot intentionally wait more than 12 months after date of death to open a probate and thereby avoid TennCare's claim for reimbursement, if applicable. Patti Killingsworth is an Assistant Commissioner for TennCare and the Chief of Long-Term Services & Supports (LTSS). A recent audit of Tennessee Medicare found that of the $2 billion in certified public expenditures it claimed during the audit period of 2009 to 2014, $909.4 million was allowable while $1.1 billion was not. You only have to pick one: Call TennCare Connect for free at 855-259-0701. If you have no way to get to your covered health services, you can call to get a ride. Cookie Policy. From in or around October 2018 to the present, Lucas allegedly caused his pharmacies to submit nearly $4 million in claims to Medicare and TennCare for dispensing expensive foot bath medications that were not medically necessary and would not have been eligible for reimbursement. This may require registering for a care provider Tenncare Medicaid ID number for reimbursement.

1200-13-01-.11 Medical (Level of Care) Eligibility Criteria for TennCare Reimbursement of Care for Children in the Katie Beckett Program 1200-13-01-.31 TennCare Employment and Community First CHOICES (ECF CHOICES) Program 1200-13-01-.32 TennCare Katie Beckett Program Place substance of rules and other info here. Contact Tennessee Carriers at 1-866-680-0633 (TTY 711) to learn more about the mileage reimbursement program and bus passes. Payments will be issued quarterly. Bureau of TennCare . Beware of TennCare Reimbursement and Prescribing Issues TennCare Completes Implementation of the ACA’s Medicaid Registration Requirement Due to recent TennCare changes, health care providers not registered with TennCare should consider registering to avoid issues in prescribing for TennCare patients and to preserve TennCare revenue. The federal government offers Medicare coverage to individuals who are 65 years or older, have certain disabilities, and suffer from end-stage renal disease or ALS. The information in the sections below highlights eight different types of rates that may be available to your program, as well as guidance on comparing those rates. Privacy Policy. The Volunteer State is also being asked to provide the paperwork or refund another $370 million for improperly documented behavioral health services. For general HCBS information, refer to the . • No telehealth modifiers will be required for TennCare claims when submitted with place of service telehealth (POS 02). The Criminal Injuries Compensation Fund was established as a fund of last resort to financially assist innocent victims of … Care Provider Resources Employment and Community First CHOICES. Bleeding Disorder Patients and Specialty Pharmacies are seeking a correction to recent reimbursement changes promulgated by TennCare on April 1, 2017.

benefit. ... your patient, they maybe eligible for fuel reimbursement. LEXIS 438, … 5-1-2018 Due to a low collection rate of assessments and an increase in the number of paid TennCare claims, the rate for increased reimbursement is being revised from $140.30 to $122.26. All Rights Reserved. Tennessee Department of Finance and Administration . The federal government provides an uncapped reimbursement of state Medicaid spending. Mileage Reimbursement Program and Bus Passes.

The MCO must pay the hospice 95% of the Nursing Facility’s per diem, as established by the Comptroller’s Office for the Bureau of TennCare, for the enrollee’s room and board. To report fraud, waste, or abuse concerns you can call 800-690-1606 (UnitedHealthcare Community Plan tipline) or 800-433-3982 (Division of TennCare & Office of Inspector General). TennCare's Opioid Strategy. The HHS' Office of Inspector General is recommending that TennCare: TennCare objected to the first and second recommendations but agreed to the third. CPT Code 90834: Complete Guide with Reimbursement Rates [2021] CPT Code 90834 is the most common procedure code used in mental health and behavioral health billing. Found inside – Page 86By 1996 , Tennessee's health centers were losing almost $ 28 per TennCare patient visit . This created an unfunded gap in reimbursement that forced health centers to cover these losses out of PHSA grants . We have three ways to help you – rides, mileage reimbursement and bus passes. Found inside – Page 909GAO found that although TennCare met its objectives of providing health coverage to many uninsured persons while ... In the Medicare program , providers may receive reimbursement for only those expenses that are reasonable in amount and ... Contact Tennessee Carriers at 1-866-680-0633 (TTY 711) to learn more about the mileage reimbursement program and bus passes. Presently, the Bureau of TennCare will certainly file a claim against the estate of someone who received benefits. TENNESSEE TRANSPORTATION PROVIDERS. Source: TN Code Annotated, Title 56, Ch. services and eligible for reimbursement by the child’s Medicaid plan. The letter also stated, “TennCare will promulgate emergency rules before July 1 requiring that these cuts be made thereby making it State law and regulation.” Reimbursement for covered medications by the TennCare program is contingent upon a prescription issued by a licensed prescriber. The Volunteer State is also being asked to provide the paperwork or refund another $370 million for improperly documented behavioral health services. Found insideThe TMA felt that TennCare's reimbursement rates would be inadequate because of belowcost fee schedules and “overzealous MCO withholding.”11 Mark Greene, executive director of the TMA, cynically observed that “the governor couldn't ... Page updated: August 2020 . Emergency Medical Care Facilities, a company that provides services in Tennessee emergency departments, said TennCare did not follow the correct procedure for making the $50 cap rule under the Uniform Administrative Procedures Act.

Provider manuals and guides. TennCare MCC, the provider indicates he is willing to accept TennCare reimbursement as payment in full. reimbursement. On January 1, 2020, TennCare took action to update the reimbursement methodology for pharmacists providing MTM in Medicaid through the Pilot Program that began on January 1, 2018. Current State Laws & Reimbursement Policies — from the National Policy Center - Center for Connected Health Policy Medicare payment policies during COVID-19 The Centers for Medicare & Medicaid Services has expanded coverage for telehealth services and providers during the COVID-19 public health emergency. Applies to: BlueCare Tennessee . Found inside – Page 428State lawmakers did enact several increases with regard to health care provider reimbursements , benefits and ... TennCare replaced the state's traditional Medicaid program in 1994 , as a managed care program serving Medicaid enrollees ... 21PED1098795-2 (6/21) Members assigned to a Health Link enjoy the benefits of improved access to behavioral health care providers and more integrated primary and behavioral health care. Reimbursement Guidelines for Procedures Performed by Two Surgeons . Found insidePrior to TennCare , Tennessee's Medicaid program paid generously with reimbursement levels at 93 % of Medicare rates ( compared with a national average of 73 % ) and additional payments to teaching hospitals for GME . There are several ways to report a change. 17. Found inside – Page 96However, fewer and fewer physicians are accepting Medicaid or its state-based managed care counterparts like Tenncare or MediCal because of problems with reimbursement and difficulties in getting patients the type of care they need. The information to indicate a provider is an eligible qualified provider will be received as follows: a. 13. Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. Found inside – Page 458At the same time , it has gone $ 80 million in the hole to cover losses from TennCare's reimbursement policies . Vanderbilt isn't the only hospital to be adversely affected , and physician groups complain that the program's managed ... Each insurer that offers a TennCare plan has a unique policy, but it is required to comply with Tenn. Code Ann. A library of the forms most frequently used by health care professionals. Claims for preventive services must be filed using the appropriate CPT® code with diagnosis codes V20-V20.2 and V70.0, V70.3 - V70.9. This and other UnitedHealthcare Community Plan reimbursement policies may use CPT, CMS or other coding methodologies from time to time. The purpose of this amendment to temporarily increase payment rates for state plan home and community-based services through quarterly supplemental payments based upon a percentage of Medicaid allowable paid claims in order to maintain a stable workforce … Found inside – Page 201Then the insurance companies decreased their reimbursement to exactly the same amount Medicare paid. TennCare eventually took about sixty-five percent of the state budget. The privately-held insurance companies like Blue Cross found ... Copyright © 2021 Becker's Healthcare. The Court of Appeals of Tennessee said October 7 that a $50 reimbursement cap imposed by TennCare for non-emergent medical services provided by emergency department physicians was not a "rule" under the Uniform Administrative Procedures Act (UAPA) and thus didn’t require notice and comment rulemaking to implement. This section contains a list of procedure codes and maximum reimbursement amounts for the Home and Community-Based Services (HCBS) program. Welcome to the OptumRx and TennCare website where you can find information to meet your pharmacy needs. Our … 1200-13-17. Found inside – Page 144As we understand it, a drug would not qualify for reimbursement under TennCare unless a classic double-blind test with patients had been performed (which TennCare would not pay for). The requirement that the “scientific evidence” he ... See also In re Estate of Gregory , 2012 Tenn. Ct. App. Please see the attached memo from TennCare regarding the 1% reimbursement reduction. the claim of TennCare will be satisfied from the sale of the home. Found inside – Page 360The medical association felt that TennCare's reimbursement rates would be inadequate because of below - cost fee schedules and " overzealous MCO withholding " ( Tennessee Medical Association , 1993 ) . In 1994 , Mark Greene , director ... However, reimbursement for administering the vaccine will vary by line of business. Parent is not enrolled in the same Group Health plan as the child 2. Therefore, they may file whatever amount they want, but the reimbursement will be zero. TennCare Director Stephen Smith told WPLN that he plans to appeal the findings  if necessary. оٿô9L¶Û-áínߤ'ŒÓLsxÚ¦'b–ì×éI=Kþ–êuW¢rÆ3!BlO¢°E–«ö#´ðã¿­ÝÒ.ù¾³¢ÃßÿŠ¯ñKo×OD2Oé×UÊ*®7ü ÇÒM»’Þ5i5K®SóŠ¦Ð4>)»µw‘‰ZeŒ…;zKäÃ÷0–Ï6‘±’Á¨bå$½u’“Ñu8pˆ‡8ٝ°¶"gÉÜß³! TennCare. 8 Claims Billing Reminders + Hospital reimbursement for member confinement on Jan. 1, 2015 will be reimbursed under transition rules + For members hospitalized prior to January 1, and continuing to be

We have three ways to help you – rides, mileage reimbursement and bus passes. For general questions, eligibility verification or Medicare Cross-Over Claim questions, contact TennCare Provider Services at 1-800-852-2683. The Centers for Medicare & Medicaid Services (CMS) implemented the Payment Error Rate Measurement (PERM) program to measure improper payments in Medicaid. TennCare CHOICES . Linking and Reprinting Policy. The book explains the technical aspects of reimbursement in language that is easy to comprehend. It illustrates the complexities of the hospital revenue cycle and explains the Medicare and Medicaid financial models in detail. TennCare program, the personal representative of the estate shall file with the clerk of the court exercising probate jurisdiction a release from ... reimbursement of correctly paid nursing home benefits from a beneficiary’s estate pursuant to T.C.A. 310 Great Circle Road . TennCare will maintain a file of providers who are qualified and eligible to receive the increased primary care payments for the purpose of reimbursing Medicare/Medicaid crossover claims in accordance with ACA.

UnitedHealthcare Community Plan will temporarily reimburse telehealth services for TennCare members provided by qualified health care professionals. 1200-13-14. TennCare Patient Centered Medical Home: Provider Operating Manual 2021. The purpose of this amendment to temporarily increase payment rates for state plan home and community-based services through quarterly supplemental payments based upon a percentage of Medicaid allowable paid claims in order to maintain a stable workforce … As required by federal law, TennCare reimburses hospitals for emergency medical services (EMS) for certain non-citizens. Criminal Injuries Compensation Fund. These noncitizens include qualified aliens subject to the 5-year bar and non-qualified aliens who are not eligible for regular TennCare because of their immigration status. current Medicare reimbursement and expressed TennCare reimbursement as a percentage of Medicare reimbursement for each hospital. Found inside – Page 3803.2 Medicaid ( TennCare ) Database 3.2.1 Implementation of Tenn Care During year 1 of the grant , the State of Tennessee implemented a sudden and ... However , TennCare shifted the responsibility for provider reimbursement from the ... Help for individuals with intellectual or developmental disabilities who want to find a job or be more involved in their community. Do not use any existing bookmarks to access the log-in page. Purpose: To provide clarification on guidelines related to the reimbursement of claims for inpatient and outpatient emergency services, furnished by a qualified provider, regardless of Select – Statewide 1-866-473-7565 . All Rights Reserved. Found insideA 1995 article in the Memphis Commercial Appeal urged a waitand-see approach: “Getting TennCare to work the way it was supposed to will take time, patience and further reform.” Physicians complained about low reimbursement rates, ... TennCare released the memo on November 2, 2021. We are working to … Select . The different reimbursement rates available to your LTSS program can be highly complex. TennCare Standard. Found inside – Page 764TennCare payments are so low that physicians , hospitals , pharmacists and other providers of health care will leave ... A privatized , market - driven system like TennCare will move the system to an appropriate level of reimbursement . An addition to hospice reimbursement is made in this situation to take into account the room and board provided by the facility. Abstract. If so, please contact Provider Services at the member's Managed Care Organization for MCO claims. CMS pharmacy reimbursement methodology requirements. TennCare Reimbursement of Care in Nursing Waiver for Persons with Mental Retardation Facilities, CHOICES HCBS and PACE Under Section 1915(c) of the Social Security Act 1200-13-01-.11 (Arlington MR Waiver) through 1200-13-01-.29 Tennessee’s Self-Determination Waiver Provider Assessment Form Reimbursement for 2021 Returning to Regular Schedule Medicare Advantage and BlueCare Plus Tennessee New Provider Advanced Illness and Frailty Exclusions WebEx Presentations Complete Special Needs Plan Model of Care Training Before Dec. 31, 2020 Pharmacy Refer to the TennCare Pharmacy Benefit Manager for Important Updates • With the exception of the “Branded Drugs Classified as Generics” list, TennCare is a mandatory generic program in accordance with state law (TCA 53 -10-205). Approval of a branded product when a generic is available Chattanooga, TN 374 02-0001 . OIG audit finds TennCare may owe $400M after alleged inflated reimbursement.

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tenncare reimbursement